Flinders Digital Health Research Centre Collected Works

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    A conceptual framework for secure mobile health
    (International Society for Telemedicine and eHealth, 2013) William, P; Maeder, Anthony
    Mobile health is characterised by its diversity of applicability, in a multifaceted and multidisciplinary healthcare delivery continuum. In an environment of rapid change with the increasing development of mobile health, issues related to security and privacy must be well thought out. The different competing tensions in the development of mobile health from the device technologies and associated regulation, to clinical workflow and patient acceptance, require a framework for security that reflects the complex structure of this emerging field. There are three distinct associated elements that require investigation: technology, clinical, and human factors. Each of these elements consists of multiple aspects and there are specific risk factors to be addressed successively and co-dependently in each case. The fundamental approach to defining a conceptual framework for secure use of mobile health requires systematic identification of properties for the tensions and critical factors which impact these elements. The resulting conceptual framework presented here can be used for new critique, augmentation or deployment of mobile health solutions from the perspective of data protection and security.
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    WALK 2.0: Examining the effectiveness of Web 2.0 features to increase physical activity in a ‘real world’ setting: an ecological trial protocol
    (BMJ Publishing Group, 2014-10-10) Caperchione, Cristina M; Kolt, Gregory S; Savage, Trevor N; Rosenkranz, Richard R; Maeder, Anthony; Vandelanotte, Corneel; Duncan, Mitch J; van Itallie, Anetta K; Tague, Rhys; Mummery, W Kerry
    Introduction: Low levels of health-enhancing physical activity require novel approaches that have the potential to reach broad populations. Web-based interventions are a popular approach for behaviour change given their wide reach and accessibility. However, challenges with participant engagement and retention reduce the long-term maintenance of behaviour change. Web 2.0 features present a new and innovative online environment supporting greater interactivity, with the potential to increase engagement and retention. In order to understand the applicability of these innovative interventions for the broader population, ‘real-world’ interventions implemented under ‘everyday conditions’ are required. The aim of this study is to investigate the difference in physical activity behaviour between individuals using a traditional Web 1.0 website with those using a novel Web 2.0 website. Methods and analysis: In this study we will aim to recruit 2894 participants. Participants will be recruited from individuals who register with a pre-existing health promotion website that currently provides Web 1.0 features (http://www.10000steps.org.au). Eligible participants who provide informed consent will be randomly assigned to one of the two trial conditions: the pre-existing 10 000 Steps website (with Web 1.0 features) or the newly developed WALK 2.0 website (with Web 2.0 features). Primary and secondary outcome measures will be assessed by self-report at baseline, 3 months and 12 months, and include: physical activity behaviour, height and weight, Internet self-efficacy, website usability, website usage and quality of life. Ethics and dissemination: This study has received ethics approval from the University of Western Sydney Human Research Ethics Committee (Reference Number H8767) and has been funded by the National Health and Medical Research Council (Reference Number 589903). Study findings will be disseminated widely through peer-reviewed publications, academic conferences and local community-based presentations.
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    Recent Directions in Telemedicine: Review of Trends in Research and Practice
    (Korean Society of Medical Informatics, 2015-10-31) Wilson, L; Maeder, Anthony
    Objectives: Healthcare is now routinely delivered by telecommunications-based services in all developed countries and an increasing number of developing countries. Telemedicine is used in many clinical specialities and across numerous healthcare settings, which range from mobile patient-centric applications to complex interactions amongst clinicians in tertiary referral hospital settings. This paper discusses some recent areas of significant development and progress in the field with the purpose of identifying strong trends in both research and practice activities. Methods: To establish the breadth of new ideas and directions in the field, a review of literature was made by searching PubMed for recent publications including terms (telemedicine OR telehealth) AND (challenge OR direction OR innovation OR new OR novel OR trend), for all searchable categories. 3,433 publications were identified that have appeared since January 1, 2005 (2,172 of these since January 1, 2010), based on a search conducted on June 1, 2015. Results: The current interest areas in these papers span both synchronous telemedicine, including intensive care, emergency medicine, and mental health, and asynchronous telemedicine, including wound and burns care, dermatology and ophthalmology. Conclusions: It is concluded that two major drivers of contemporary tele medicine development are a high volume demand for a particular clinical service, and/or a high criticality of need for clinical exper tise to deliver the service. These areas offer promise for further study and enhancement of applicable telemedicine methods and have the potential for large-scale deployments internationally, which would contribute significantly to the advancement of healthcare.
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    Validity of the Stages of Change in Steps instrument (SoC-Step) for achieving the physical activity goal of 10,000 steps per day
    (BioMed Central, 2015-11-30) Rosenkranz, Richard R; Duncan, Mitch J; Caperchione, Cristina M; Kolt, Gregory S; Vandelanotte, Corneel; Maeder, Anthony; Savage, Trevor N; Mummery, W Kerry
    Background: Physical activity (PA) offers numerous benefits to health and well-being, but most adults are not sufficiently physically active to afford such benefits. The 10,000 steps campaign has been a popular and effective approach to promote PA. The Transtheoretical Model posits that individuals have varying levels of readiness for health behavior change, known as Stages of Change (Precontemplation, Contemplation, Preparation, Action, and Maintenance). Few validated assessment instruments are available for determining Stages of Change in relation to the PA goal of 10,000 steps per day. The purpose of this study was to assess the criterion-related validity of the SoC-Step, a brief 10,000 steps per day Stages of Change instrument. Methods: Participants were 504 Australian adults (176 males, 328 females, mean age = 50.8 ± 13.0 years) from the baseline sample of the Walk 2.0 randomized controlled trial. Measures included 7-day accelerometry (Actigraph GT3X), height, weight, and self-reported intention, self-efficacy, and SoC-Step: Stages of Change relative to achieving 10,000 steps per day. Kruskal-Wallis H tests with pairwise comparisons were used to determine whether participants differed by stage, according to steps per day, general health, body mass index, intention, and self-efficacy to achieve 10,000 steps per day. Binary logistic regression was used to test the hypothesis that participants in Maintenance or Action stages would have greater likelihood of meeting the 10,000 steps goal, in comparison to participants in the other three stages. Results: Consistent with study hypotheses, participants in Precontemplation had significantly lower intention scores than those in Contemplation (p = 0.003) or Preparation (p < 0.001). Participants in Action or Maintenance stages were more likely to achieve ≥10,000 steps per day (OR = 3.11; 95 % CI = 1.66,5.83) compared to those in Precontemplation, Contemplation, or Preparation. Intention (p < 0.001) and self-efficacy (p < 0.001) to achieve 10,000 steps daily differed by stage, and participants in the Maintenance stage had higher general health status and lower body mass index than those in Precontemplation, Contemplation and Preparation stages (p < 0.05). Conclusions: This brief SoC-Step instrument appears to have good criterion-related validity for determining Stages of Change related to the public health goal of 10,000 steps per day.
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    Effectiveness of a website and mobile phone based physical activity and nutrition intervention for middle-aged males: Trial protocol and baseline findings of the ManUp Study
    (BioMed Central, 2012-08-15) Duncan, Mitch J; Vandelanotte, Corneel; Rosenkranz, Richard R; Caperchione, Cristina M; Ding, Hang; Ellison, Marcus; George, Emma S; Hooker, Cindy; Karunanithi, Mohan; Kolt, Gregory S; Maeder, Anthony; Noakes, Manny; Tague, Rhys; Taylor, Pennie; Viljoen, Pierre; Mummery, W Kerry
    Background: Compared to females, males experience higher rates of chronic disease and mortality, yet few health promotion initiatives are specifically aimed at men. Therefore, the aim of the ManUp Study is to examine the effectiveness of an IT-based intervention to increase the physical activity and nutrition behaviour and literacy in middle-aged males (aged 35–54 years). Method/Design: The study design was a two-arm randomised controlled trial, having an IT-based (applying website and mobile phones) and a print-based intervention arm, to deliver intervention materials and to promote self-monitoring of physical activity and nutrition behaviours. Participants (n = 317) were randomised on a 2:1 ratio in favour of the IT-based intervention arm. Both intervention arms completed assessments at baseline, 3, and 9 months. All participants completed self-report assessments of physical activity, sitting time, nutrition behaviours, physical activity and nutrition literacy, perceived health status and socio-demographic characteristics. A randomly selected sub-sample in the IT-based (n = 61) and print-based (n = 30) intervention arms completed objective measures of height, weight, waist circumference, and physical activity as measured by accelerometer (Actigraph GT3X). The average age of participants in the IT-based and print-based intervention arm was 44.2 and 43.8 years respectively. The majority of participants were employed in professional occupations (IT-based 57.6%, Print-based 54.2%) and were overweight or obese (IT-based 90.8%, Print-based 87.3%). At baseline a lower proportion of participants in the IT-based (70.2%) group agreed that 30 minutes of physical activity each day is enough to improve health compared to the print-based (82.3%) group (p = .026). The IT-based group consumed a significantly lower number of serves of red meat in the previous week, compared to the print-based group (p = .017). No other significant between-group differences were observed at baseline. Discussion: The ManUp Study will examine the effectiveness of an IT-based approach to improve physical activity and nutrition behaviour and literacy. Study outcomes will provide much needed information on the efficacy of this approach in middle aged males, which is important due to the large proportions of males at risk, and the potential reach of IT-based interventions.
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    WALK 2.0 - Using Web 2.0 applications to promote health-related physical activity: A randomised controlled trial protocol
    (BioMed Central, 2013-05-03) Kolt, Gregory S; Rosenkranz, Richard R; Savage, Trevor N; Maeder, Anthony; Vandelanotte, Corneel; Duncan, Mitch J; Caperchione, Cristina M; Tague, Rhys; Hooker, Cindy; Mummery, W Kerry
    Background: Physical inactivity is one of the leading modifiable causes of death and disease in Australia. National surveys indicate less than half of the Australian adult population are sufficiently active to obtain health benefits. The Internet is a potentially important medium for successfully communicating health messages to the general population and enabling individual behaviour change. Internet-based interventions have proven efficacy; however, intervention studies describing website usage objectively have reported a strong decline in usage, and high attrition rate, over the course of the interventions. Web 2.0 applications give users control over web content generated and present innovative possibilities to improve user engagement. There is, however, a need to assess the effectiveness of these applications in the general population. The Walk 2.0 project is a 3-arm randomised controlled trial investigating the effects of “next generation” web-based applications on engagement, retention, and subsequent physical activity behaviour change. Methods/design: 504 individuals will be recruited from two sites in Australia, randomly allocated to one of two web-based interventions (Web 1.0 or Web 2.0) or a control group, and provided with a pedometer to monitor physical activity. The Web 1.0 intervention will provide participants with access to an existing physical activity website with limited interactivity. The Web 2.0 intervention will provide access to a website featuring Web 2.0 content, including social networking, blogs, and virtual walking groups. Control participants will receive a logbook to record their steps. All groups will receive similar educational material on setting goals and increasing physical activity. The primary outcomes are objectively measured physical activity and website engagement and retention. Other outcomes measured include quality of life, psychosocial correlates, and anthropometric measurements. Outcomes will be measured at baseline, 3, 12 and 18 months. Discussion: The findings of this study will provide increased understanding of the benefit of new web-based technologies and applications in engaging and retaining participants on web-based intervention sites, with the aim of improved health behaviour change outcomes.
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    Examining Participant Engagement in an Information Technology-Based Physical Activity and Nutrition Intervention for Men: The Manup Randomized Controlled Trial
    (JMIR Publications, 2014-01-03) Short, Camille E; Vandelanotte, Corneel; Dixon, Marcus W; Rosenkranz, Richard R; Caperchione, Cristina M; Hooker, Cindy; Karunanithi, Mohan; Kolt, Gregory S; Maeder, Anthony; Ding, Hang; Taylor, Pennie; Duncan, Mitch J
    Background:Males experience a shorter life expectancy and higher rates of chronic diseases compared to their female counterparts. To improve health outcomes among males, interventions specifically developed for males that target their health behaviors are needed. Information technology (IT)-based interventions may be a promising intervention approach in this population group, however, little is known about how to maximize engagement and retention in Web-based programs. Objective:The current study sought to explore attributes hypothesized to influence user engagement among a subsample of participants from the ManUp study, a randomized controlled trial testing the efficacy of an interactive Web-based intervention for promoting physical activity and nutrition among middle-aged males. Methods: Semistructured interviews were conducted and audiotaped with 20 of the ManUp participants. Interview questions were based on a conceptual model of engagement and centered on why participants took part in the study, what they liked and did not like about the intervention they received, and how they think the intervention could be improved. Interview recordings were transcribed and coded into themes. Results: There were five themes that were identified in the study. These themes were: (1) users’ motives, (2) users’ desired outcomes, (3) users’ positive experiences, (4) users’ negative emotions, and (5) attributes desired by user. Conclusions: There is little research in the field that has explored user experiences in human-computer interactions and how such experiences may relate to engagement, especially among males. Although not conclusive, the current study provides some insight into what personal attributes of middle-aged males (such as their key motives and goals for participating) and attributes of the intervention materials (such as usability, control, and interactivity) may impact on user engagement in this group. These findings will be helpful for informing the design and implementation of future health behavior interventions for males.
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    Clustering Multivariate Time Series Using Hidden Markov Models
    (MDPI, 2014-03-06) Ghassem Pour, S; Girosi, F; Maeder, Anthony
    In this paper we describe an algorithm for clustering multivariate time series with variables taking both categorical and continuous values. Time series of this type are frequent in health care, where they represent the health trajectories of individuals. The problem is challenging because categorical variables make it difficult to define a meaningful distance between trajectories. We propose an approach based on Hidden Markov Models (HMMs), where we first map each trajectory into an HMM, then define a suitable distance between HMMs and finally proceed to cluster the HMMs with a method based on a distance matrix. We test our approach on a simulated, but realistic, data set of 1,255 trajectories of individuals of age 45 and over, on a synthetic validation set with known clustering structure, and on a smaller set of 268 trajectories extracted from the longitudinal Health and Retirement Survey. The proposed method can be implemented quite simply using standard packages in R and Matlab and may be a good candidate for solving the difficult problem of clustering multivariate time series with categorical variables using tools that do not require advanced statistic knowledge, and therefore are accessible to a wide range of researchers.
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    Recruitment, screening, and baseline participant characteristics in the WALK 2.0 study: A randomized controlled trial using web 2.0 applications to promote physical activity
    (Elsevier, 2016-04) Caperchione, Cristina M; Duncan, Mitch J; Rosenkranz, Richard R; Vandelanotte, Corneel; van Itallie, Anetta K; Savage, Trevor N; Hooker, Cindy; Maeder, Anthony; Mummery, W Kerry; Kolt, Gregory S
    Objective: To describe in detail the recruitment methods and enrollment rates, the screening methods, and the baseline characteristics of a sample of adults participating in the Walk 2.0 Study, an 18 month, 3-arm randomized controlled trial of a Web 2.0 based physical activity intervention. Methods: A two-fold recruitment plan was developed and implemented, including a direct mail-out to an extract from the Australian Electoral Commission electoral roll, and other supplementary methods including email and telephone. Physical activity screening involved two steps: a validated single-item self-report instrument and the follow-up Active Australia Questionnaire. Readiness for physical activity participation was also based on a two-step process of administering the Physical Activity Readiness Questionnaire and, where needed, further clearance from a medical practitioner. Results: Across all recruitment methods, a total of 1244 participants expressed interest in participating, of which 656 were deemed eligible. Of these, 504 were later enrolled in the Walk 2.0 trial (77% enrollment rate) and randomized to the Walk 1.0 group (n = 165), the Walk 2.0 group (n = 168), or the Logbook group (n = 171). Mean age of the total sample was 50.8 years, with 65.2% female and 79.1% born in Australia. Conclusion: The results of this recruitment process demonstrate the successful use of multiple strategies to obtain a diverse sample of adults eligible to take part in a web-based physical activity promotion intervention. The use of dual screening processes ensured safe participation in the intervention. This approach to recruitment and physical activity screening can be used as a model for further trials in this area.
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    Effectiveness of a Web- and Mobile Phone-Based Intervention to Promote Physical Activity and Healthy Eating in Middle-Aged Males: Randomized Controlled Trial of the ManUp Study
    (Journal of Medical Internet Research, 2014) Duncan, Mitch J; Vandelanotte, Corneel; Kolt, Gregory S; Rosenkranz, Richard R; Caperchione, Cristina M; George, Emma S; Ding, Hang; Hooker, Cindy; Karunanithi, Mohan; Maeder, Anthony; Noakes, Manny; Tague, Rhys; Taylor, Pennie; Viljoen, Pierre; Mummery, W Kerry
    Background: The high number of adult males engaging in low levels of physical activity and poor dietary practices, and the health risks posed by these behaviors, necessitate broad-reaching intervention strategies. Information technology (IT)-based (Web and mobile phone) interventions can be accessed by large numbers of people, yet there are few reported IT-based interventions targeting males’ physical activity and dietary practices. Objective: This study examines the effectiveness of a 9-month IT-based intervention (ManUp) to improve the physical activity, dietary behaviors, and health literacy in middle-aged males compared to a print-based intervention. Methods: Participants, recruited offline (eg, newspaper ads), were randomized into either an IT-based or print-based intervention arm on a 2:1 basis in favor of the fully automated IT-based arm. Participants were adult males aged 35-54 years living in 2 regional cities in Queensland, Australia, who could access the Internet, owned a mobile phone, and were able to increase their activity level. The intervention, ManUp, was based on social cognitive and self-regulation theories and specifically designed to target males. Educational materials were provided and self-monitoring of physical activity and nutrition behaviors was promoted. Intervention content was the same in both intervention arms; only the delivery mode differed. Content could be accessed throughout the 9-month study period. Participants’ physical activity, dietary behaviors, and health literacy were measured using online surveys at baseline, 3 months, and 9 months. Results: A total of 301 participants completed baseline assessments, 205 in the IT-based arm and 96 in the print-based arm. A total of 124 participants completed all 3 assessments. There were no significant between-group differences in physical activity and dietary behaviors (P≥.05). Participants reported an increased number of minutes and sessions of physical activity at 3 months (exp(β)=1.45, 95% CI 1.09-1.95; exp(β)=1.61, 95% CI 1.17-2.22) and 9 months (exp(β)=1.55, 95% CI 1.14-2.10; exp(β)=1.51, 95% CI 1.15-2.00). Overall dietary behaviors improved at 3 months (exp(β)=1.07, 95% CI 1.03-1.11) and 9 months (exp(β)=1.10, 95% CI 1.05-1.13). The proportion of participants in both groups eating higher-fiber bread and low-fat milk increased at 3 months (exp(β)=2.25, 95% CI 1.29-3.92; exp(β)=1.65, 95% CI 1.07-2.55). Participants in the IT-based arm were less likely to report that 30 minutes of physical activity per day improves health (exp(β)=0.48, 95% CI 0.26-0.90) and more likely to report that vigorous intensity physical activity 3 times per week is essential (exp(β)=1.70, 95% CI 1.02-2.82). The average number of log-ins to the IT platform at 3 and 9 months was 6.99 (SE 0.86) and 9.22 (SE 1.47), respectively. The average number of self-monitoring entries at 3 and 9 months was 16.69 (SE 2.38) and 22.51 (SE 3.79), respectively. Conclusions: The ManUp intervention was effective in improving physical activity and dietary behaviors in middle-aged males with no significant differences between IT- and print-based delivery modes.
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    An Internet-supported Physical Activity Intervention Delivered in Secondary Schools Located in Low Socio-economic Status Communities: Study Protocol for the Activity and Motivation in Physical Education (AMPED) Cluster Randomized Controlled Trial
    (2016) Lonsdale, Chris; Lester, Aidan; Owen, Katherine B; White, Rhiannon L; Moyes, Ian; Peralta, Louisa; Kirwan, Morwenna; Maeder, Anthony; Bennie, Andrew; MacMillan, Freya; Kolt, Gregory S; Ntoumanis, Nikos; Gore, Jennifer M; Cerin, Ester; Diallo, Thierno M O; Cliff, Dylan P; Lubans, David R
    School-based physical education is an important public health initiative as it has the potential to provide students with regular opportunities to participate in moderate-to-vigorous physical activity (MVPA). Unfortunately, in many physical education lessons students do not engage in sufficient MVPA to achieve health benefits. In this trial we will test the efficacy of a teacher professional development intervention, delivered partially via the Internet, on secondary school students’ MVPA during physical education lessons. Teaching strategies covered in this training are designed to (i) maximize opportunities for students to be physically active during lessons and (ii) enhance students’ autonomous motivation towards physical activity.
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    Cloud-based Medical Image Collection Database with Automated Annotation
    (IARIA, 2016) Maeder, Anthony; Planitz, B
    Typical medical image annotation systems use manual annotation or complex proprietary software such as computer-assisted-diagnosis. A more objective approach is required to achieve generalised Content Based Image Retrieval (CBIR) functionality. The Automated Medical Image Collection Annotation (AMICA) toolkit described here addresses this need. A range of content analysis functions are provided to tag images and image regions. The user uploads a DICOM file to an online portal and the software finds and displays images that have similar characteristics. AMICA has been developed to run in the Microsoft cloud environment using the Windows Azure platform, to cater for the storage requirements of typical large medical image databases.
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    Simulated Artificial Human Vision: The Effects of Spatial Resolution and Frame Rate on Mobility
    (IOS Press, 2006) Dowling, Jason A; Boles, Wageeh; Maeder, Anthony
    Electrical stimulation of the human visual system can result in the perception of blobs of light, known as phosphenes. Artificial Human Vision (AHV or visual prosthesis) systems use this method to provide a visual substitute for the blind. This paper reports on our experiments involving normally sighted participants using a portable AHV simulation. A Virtual Reality Head Mounted Display is used to display the phosphene simulation. Custom software converts captured images from a head mounted USB camera to a DirectX based phosphene simulation. The effects of frame rate (1, 2 and 4 FPS) and phosphene spatial resolution (16x12 and 32x24) on participant Percentage of Preferred Walking Speed (PPWS) and mobility errors were assessed during repeated trials on an artificial indoor mobility course. Results indicate that spatial resolution is a significant factor in reducing contact with obstacles and following a path without veering, however the phosphene display frame rate is a better predictor of a person’s preferred walking speed. These findings support the development of an adaptive display which could provide a faster display with reduced spatial resolution when a person is walking comfortably and a slower display with higher resolution when a person has stopped moving.
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    e-Research Meets e-Health
    (Australian Computer Society, 2008) Maeder, Anthony
    This paper considers some key aspects of e-Research methodology and infrastructure which are relevant to e-Health, and identifies some promising areas in e-Health where these aspects could be used beneficially .
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    Characterizing Image Properties for Digital Mammograms
    (Australian Computer Society, 2009) Nguyen, Anthony; Dowling, Jason A; Maeder, Anthony; Nguyen, Phuong; Brunton, Emma
    Adoption of computed radiology (CR) and direct radiology (DR) imaging for screening mammograms in many countries alongside digitally scanned film mammograms has resulted in a wide range of different intrinsic (physical) characteristics of images becoming commonplace. It is sometimes conjectured that viewer performance could be adversely affected by this wider variability, as compared with the variability that was formerly experienced with film only. This paper identifies several aspects of the image characteristics relevant to viewer perception, including intensity properties (such as contrast), spatial properties (such as texture) and structure properties (such as breast density). We then provide quantitative descriptions of the variability of these properties over a test set of 12 screening mammograms drawn from three different modalities and containing a typical mix of screening cases..
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    Assessing Viewing Pattern Consistency in Mammogram Readers
    (Australian Computer Society, 2009) Maeder, Anthony; Fookes, C
    Breast cancer screening programs typically require very large volumes of x-ray images (mammograms) to be viewed by highly experienced human readers. The readers can recognise a wide range of different visible features indicative of clinically abnormal situations, which they use as a basis to generate a report on their findings. Errors in reporting can occur if the readers fail to identify a particular feature of interest for further visual inspection during the viewing process. This risk is typically reduced by training readers to follow a particular viewing path through an image, which they should be able to apply consistently. Knowledge of the extent of consistency in this viewing behaviour within and between viewers would inform the development of an automated checking approach, based on monitoring of viewer visual attention. This paper presents an analysis of some reader viewing pattern profiles obtained using eye tracking with an infra red computer vision system, as a basis for developing a suitable consistency assessment model. .
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    Comparing Data Mining with Ensemble Classification of Breast Cancer Masses in Digital Mammograms
    (AIH, 2012) Ghassem Pour, S; McLeod, P; Verma, B; Maeder, Anthony
    Medical diagnosis sometimes involves detecting subtle indi-cations of a disease or condition amongst a background of diverse healthy individuals. The amount of information that is available for discover-ing such indications for mammography is large and has been growing at an exponential rate, due to population wide screening programmes. In order to analyse this information data mining techniques have been utilised by various researchers. A question that arises is: do flexible data mining techniques have comparable accuracy to dedicated classification techniques for medical diagnostic processes? This research compares a model-based data mining technique with a neural network classification technique and the improvements possible using an ensemble approach. A publicly available breast cancer benchmark database is used to determine the utility of the techniques and compare the accuracies obtained.
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    Constructing a Synthetic Longitudinal Health Dataset for Data Mining
    (IARIA, 2012) Ghassem Pour, S; Maeder, Anthony; Jorm, L
    The traditional approach to epidemiological research is to analyse data in an explicit statistical fashion, attempting to answer a question or test a hypothesis. However, increasing experience in the application of data mining and exploratory data analysis methods suggests that valuable information can be obtained from large datasets using these less constrained approaches. Available data mining techniques, such as clustering, have mainly been applied to cross-sectional point-in-time data. However, health datasets often include repeated observations for individuals and so researchers are interested in following their health trajectories. This requires methods for analysis of multiple-points-over-time or longitudinal data. Here, we describe an approach to construct a synthetic longitudinal version of a major population health dataset in which clusters merge and split over time, to investigate the utility of clustering for discovering time sequence based patterns.
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    Validating Synthetic Health Datasets for Longitudinal Clustering
    (2013) Ghassem Pour, S; Maeder, Anthony; Jorm, L
    Clustering methods partition datasets into subgroups with some homogeneous properties, with information about the number and particular characteristics of each subgroup unknown a priori. The problem of predicting the number of clusters and quality of each cluster might be overcome by using cluster validation methods. This paper presents such an approach in-corporating quantitative methods for comparison be-tween original and synthetic versions of longitudinal health datasets. The use of the methods is demon-strated by using two different clustering algorithms, K-means and Latent Class Analysis, to perform clus-tering on synthetic data derived from the 45 and Up Study baseline data, from NSW in Australia.
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    Evaluation Study of Australian Telehealth Projects
    (Australian Computer Society, 2015-01-27) Poultney, N; Maeder, Anthony; Basilakis, J
    This paper provides an overview of selected telehealth projects involving pilot or trial implementations, undertaken in Australia in the period since 2000, which have undergone substantial formal evaluations reported in the peer reviewed scientific literature. Barriers and enablers reported for these telehealth projects are identified and the evaluation aspects are presented using a recently proposed generalised evaluation framework.